Economic modeling for the US of the cost-efficiency and associated expanded treatment access of conversion to biosimilar pegfilgrastim-bmez from reference pegfilgrastim

Abstract

Aims: For this economic analysis, we aimed to model: (1) the cost-efficiency of prophylaxis with biosimilar pegfilgrastim-bmez for chemotherapy-induced (febrile) neutropenia (CIN/FN) compared to reference pegfilgrastim, and (2) the expanded access to CIN/FN prophylaxis and anti-neoplastic treatment that could be achieved with biosimilar cost-savings on a budget-neutral basis.

Methods: In a hypothetical panel of 20,000 cancer patients receiving CIN/FN prophylaxis and using the average sales price (ASP) for the second quarter of 2019 for reference pegfilgrastim, we: conducted an ex ante simulation from the payer perspective of the cost-savings of 10–100% conversion from reference to biosimilar pegfilgrastim-bmez using drug price discounting ranging from 10–35%; estimated the budget-neutral expanded access to biosimilar pegfilgrastim-bmez enabled by these cost-savings; and estimated the budget-neutral expanded access to anti-neoplastic treatment with pembrolizumab. The simulations were replicated using fourth quarter 2019 wholesale acquisition cost (WAC) for reference pegfilgrastim and biosimilar pegfilgrastim-bmez in a post facto analysis.

Results: In ASP simulations, cost-savings of using pegfilgrastim-bmez over reference pegfilgrastim in a 20,000 patient panel range from $1.3?M (at 15% price discount) to $3?M (35%) at 10% conversion rate and from $6.4?M to $14.9?M, respectively, at 50% conversion. These savings could provide prophylaxis with pegfilgrastim-bmez to an additional 352 (15% discount) to 1,076 patients (35%) at 10% conversion or 1,764–5,384, respectively, at 50% conversion. Alternatively, savings could be reallocated for anti-neoplastic treatment with pembrolizumab to 3 (15% discount) to 9 (35%) patients at 10% conversion or 19–45, respectively, at 50% conversion. When utilizing WAC, cost-savings range from $4.6?M (10% conversion) to $23.1?M (50%) which could provide pegfilgrastim-bmez to an additional 1,174 (10% conversion) to 5,873 patients (50%).

Conclusions: Prophylaxis with biosimilar pegfilgrastim-bmez increases the value of cancer care by generating significant cost-savings that could be reallocated to provide expanded access to CIN/FN prevention and anti-neoplastic therapy on a budget-neutral basis.     

Application of social media analytics in tourism crisis communication

Given the newly established communication environment of social media and highly unpredictable crisis situations, this study questioned how tourists facing an unexpected crisis situation use social media to communicate and search for information. To this end, this study developed a multi-phased social media analytic framework (data crawling, data processing and text mining, social network analysis, semantic network analysis, and network visualization) to assess the structure of information exchanges between the members of a tourism organization’s social network community and identified influential actors and information content within the social network. This study’s findings suggest genuine ways of relating with and utilizing opinion leaders and influencers in social media marketing communication as well as crisis communication. The authors expect this proposed methodological framework of social media analytics to help other scholars scientifically identify and implement the proper methodologies for utilizing social media data.     

The role of brand personality,self-congruity,and sensory experience in elucidating sky lounge users’ behavior

This study attempted to develop an integrated model linking brand personality, self-image congruity, hedonic and utilitarian values, and behavioral intentions in the sky lounge context. Our results indicated that brand personality was significantly related to self-image congruity, which in turn influenced hedonic and utilitarian values. While hedonic value significantly affected intentions to revisit and recommend, utilitarian value significantly influenced intention to recommend. Moreover, self-image congruity and values played a significant mediating role. Furthermore, the links from hedonic value to intentions to revisit and recommend, and from utilitarian value to intention to revisit were significantly moderated by sensory experience.     

A Study on Flow Experience Structures: Enhancement or Death,Prospects for the Korean Wave

In proposing the concept of flow which focuses on experiencing the sites visited by Korean Wave tourists as induced by drama or movies, the role of involvement level (variables) of Korean Wave tourists in influencing flow construct as they experience the sites of FIT (Film Induced Tourism) was investigated. The involvement level of Korean Wave visitors was found to operate as a mechanism by which challenge, skills, and focused attention on site might be more organized or more actively experienced. This recognizes that there is clearly a need for making the FIT sites exposed much by any mix of various media. The findings of this study showed that challenges and skills influence enjoyment as an output factor of flow. Film site visitors are assumed to participate in the roles of film characters, experiencing the places and the atmosphere. The degree of visitors' reflections of the film optimizes awareness of flow experiences on the site. Therefore it is necessary to provide more detailed experiential programs on the film sites with a wide variety of flow-related contents in the film.     

Employee stock ownership and financial performance in European countries: The moderating effects of uncertainty avoidance and social trust

This study investigates how the effect of employee stock ownership on financial performance may hinge on the diverse cultural and societal contexts of European countries. Based on agency and national culture theories, we hypothesize that the positive relationship between employee stock ownership and return on assets (ROA) is stronger in those nations with lower uncertainty avoidance and higher social trust. Using a multisource, time‐lagged, large‐scale dataset of 1,741 firms from 21 countries in Europe, our multilevel, random coefficient modeling analysis found evidence for these hypotheses, suggesting that uncertainty avoidance and social trust serve as important contextual cues in predicting the linkage between employee stock ownership and financial performance. Our supplemental analysis with distinction between the managerial and nonmanagerial employee stock ownership further indicates managerial employee stock ownership has a direct positive effect on ROA. Although nonmanagerial employee stock ownership had a nonsignificant association with ROA, the relationship was positive and significant when uncertainty avoidance was low and social trust was high. This research contributes to the existing literature by illuminating some of the contextual influences altering the effectiveness of employee stock ownership. Our findings also offer practical suggestions for effectively using employee stock ownership.     

In the wake of conflict: the long-term effect on child nutrition in Uganda

The Lord’s Resistance Army (LRA) insurgency from 1986 to 2006 is one of the longest conflicts in Uganda. This paper examines the effect of the LRA insurgency on child nutrition using the 2011 Uganda Demographic and Health Survey. The distance from each village to the border of South Sudan is used as an instrument for identifying the intensity of the conflict. We find that each conflict event in a village lowers weight-for-age z-scores and weight-for-height z-scores for children born after the conflict. We further investigate a possible heterogeneous conflict effect on child nutrition in terms of gender, region, and maternal education. Low household wealth, limited access to healthcare, and poor maternal nutrition appear to be channels through which the conflict inhibits the growth and development of children 5 years after the end of the conflict.     

The relationships among overall quick-casual restaurant image,perceived value,customer satisfaction,and behavioral intentions

The purpose of this research is to explain the relationships among overall quick-casual restaurant image, perceived value, customer satisfaction, and behavioral intentions in the quick-casual restaurant industry. The findings indicate that overall quick-casual restaurant image significantly influences perceived value, and overall quick-casual restaurant image and perceived value had a significant role in influencing customer satisfaction. Additionally, overall quick-casual restaurant image, perceived value, and customer satisfaction are significant predictors of customers’ behavioral intentions. Finally, customer satisfaction can act as a partial mediator in the relationship between overall quick-casual restaurant image/perceived value and behavioral intentions. Furthermore, we discuss the theoretical and managerial implications of the findings and future research ideas.     

User-generated product reviews on the internet: the drivers and outcomes of the perceived usefulness of product reviews

This study examines how people cope with the user-generated product reviews (UGPRs) found on various websites where anonymous web users post and share their personal product usage experiences. Based on information processing model of communication, we postulate that there are source, message, media, and receiver factors to influence individuals' psychological processing of the UGPR messages, and its subsequent behavioral outcomes. A survey was administered by a professional market research firm to 262 randomly selected US residents from 18 to 55 years old. Consistent with the predictions, the results of the structural equation modeling analysis showed that the perceived source expertise, message objectivity, website credibility, and receiver–source similarity had positive and direct impacts on the perceptions of UGPR usefulness, which, in turn, positively influenced individuals' willingness to share product reviews with others. A series of causal model invariance tests also confirmed that the findings were statistically invariant across different subgroups divided by such factors as product categories, websites, subjective product class knowledge, past UGPR experience, and the susceptibility to informational influence.